Information
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Audit Title
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Document No.
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
Section 1. Personal Protective Equipment
1.1 Head Protection
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1.) Worn in areas where overhead hazards exist?
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2.) In good overall condition? a.) No holes drilled in shell. b.) Bill not altered/shaped. c.) Suspension in tact. d.) Worn facing the front.
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3.) Proper for the task being performed?
1.2 Eye/Face Protection
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1.) All employees are wearing ANSI Z87.1 safety glasses where potential eye hazards are present.
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2.) The correct protection is being used for the task being performed. a.) Impact resistant goggles b.) Chemical splash goggles c.) Face Shield d.) Burning Goggles (#5 Lens) e.) Welding Hood (#10 Lens)
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3.) Eye/face protection is in good overall condition and is being worn properly.
1.3 Foot Protection
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1.) Employees are wearing approved steel toe leather foot wear in the work area.
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2.) Special purpose foot protection is provided and being worn where appropriate.
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3.) Footwear is in good overall condition.
1.4 Hand Protection
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1.) General purpose work gloves are being worn to protect against splinters, sharp edges, wire rope, etc.
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2.) Special purpose gloves are being worn to protect against the hazards encountered (i.e., High Temps.)
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3.) Chemical protective gloves are being used when working with solvents or other chemicals.
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4.) Hand protection is being used as required.
1.5 Fall Protection
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1.) Fall protection is being used where required.
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2.) Proper attachment points are being used.
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3.) Lanyard is equipped with double locking snaps.
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4. Current color coding in use. a.) Suspension in tact. b.) Worn facing the front.
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5.) Harness and lanyard maintained in good condition
1.6 Hearing Protection
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1.) Hearing protection is being used in assigned areas.
1.7 Body Protection
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1.) Nomex clothing in good overall condition.
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2.) Holes in Nomex clothing is not larger that a quarter.
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3.) Nomex Clothing is not excessively soiled w/ oils or paint
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4. Nomex Clothing is worn with the zipper up.
Section 2. Mobile Equipment
2.1 Fork Trucks
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1.) Operator has been properly certified for the equipment being operated.
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2.) Equipment is being used as designed.
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3.) Inspections are being performed as required.
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a.) Daily
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b.) Monthly
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4.) Deficiencies noted during inspections are being corrected when noted.
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5.) Equipment is in good condition.
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6.) Safety equipment (i.e., seat belt) is being used during operation.
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7.) Back-up alarms are operable.
2.2 Vacuum truck
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1.) Operator has been properly certified for the equipment being operated.
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2.) Equipment is being used as designed.
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3.) Pre-trip inspection performed .
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4.) Deficiencies noted during inspections are being corrected when noted.
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5.) Area barricaded
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6.) Lift plans (where applicable) are prepared in accordance with existing procedures.
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7.) Crane is positioned on a suitable surface.
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8.) Potential electrical hazards are identified and are given distance consideration.
2.3 Hydroblasting
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1.) COMPLETE PRE-JOB SAFETY CHECKLIST CHA
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2.) Proper Barricade
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3.) proper ground confirmed
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4.) All hoses have whip checks and quartly inspection
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5.) Shot gun 66" trigger guard in place barrels and parts in good shape
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6.) Verify fail safe dump valve
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7.) Back-up alarms are operable.
2.4 Flex lance
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1.) Safe hands device properly in place with< 1/4" gap between device & tube sheet
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2.) Equipment is being used as designed.
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3.) Aerial Lift is being used to lift personnel only.
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4.) Inspections are being performed as required.
2.4 Line moling
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1.) Safe hands device properly in place with at least 2 bolts or connection points
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2.) Stinger and nozzel assembly 11/2 times larger than diameter of pipe
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3.) person inserting nozzel & hose controles dump valve.
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4.) hose marked 3 feet from nozzel
Section 3. Facilities
3.1 Exits/Exit Ways
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1.) Exits are clearly identified.
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2.) Exit routes are not obstructed.
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3.) Exit signs are in place where required.
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4.) Illumination of Exit signs is present where required.
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5.) No Hazardous Materials are stored near exit passageways
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6.) Directional signs to exit ways are provided where required.
3.2 Building Access
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1.) Adequate access has been provided.
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2.) Handrails are provided for each stairway.
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3.) Exit discharge and exit access are at the same elevation.
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4.) Stairs are secured from movement.
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5.) Stair treads are provided with non-slip surface.
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6.) Exit discharge allows for adequate door swing.
3.3 Fire Systems
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1.) Automatic sprinkler system has a current inspection.
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2.) Water supply valves are maintained in an open position.
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3.) Unprotected firewater piping is properly insulated.
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4.) Fire Dept. connections are in good condition and covered.
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5.) Fire alarm is in an operable condition.
3.4 Emergency Plans
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1.) Emergency routes are identified on a facility map.
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2.) Emergency plans are posted where employees routinely gather.
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3.) Emergency phone numbers are posted in conspicuous locations.
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4.) Personnel assembly areas are identified.
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5.) Alarm codes are addressed in the emergency plan.
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6.) Responsibilities for personnel are defined.
Section 4. Tools & Equipment
4.1 Portable Electric Tools
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1.) Overall condition of tool and cord good.
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2.) Power tools stored properly
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3.) A GFCI is in use with the tool.
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4.) Proper guards in place and being used properly.
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5.) Stress relief device is installed on electric cord.
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6.) Evidence of quarterly inspection readily visible & current.
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7.) Electric lighting cords in satisfactory condition
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9.) Electric tools unplugged when not in use
4.2 Machine Tools
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1.) All guards in place.
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2.) Pinch points eliminated at point of operation.
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3.) Emergency stops readily accessible.
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4.) Tool rest position on pedestal grinders between 1/16"/1/8" from grinding wheel.
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5.) Overall condition of tool satisfactory.
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6.) Controls clearly labeled.
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7.) Attachments such as grinding wheel, drill bit, etc., appropriate for equipment.
4.3 Hoisting and Lifting Equipment
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1.) Equipment's rated capacity clearly visible.
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2.) Hook safety latch in place and in good condition.
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3.) Inspection and maintenance logs properly maintained.
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4.) Load chart, angle indicator maintained and in good order.
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5.) Flagman used where needed or required.
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6.) Proper distance from power lines maintained.
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7.) Barricades properly installed around swing radius.
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8.) Tag line used to maintain control of load.
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9.) Qualified operator operating equipment.
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10.) Rigging practices correct for task.
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11.) All rigging material properly inspected and maintained
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12.) Critical Lift Plans used where necessary.
4.4 Welding Machines
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1.) Welding machine in good condition.
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2.) Chassis ground installed properly.
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3.) GFCI installed for electric tool use.
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4.) Welding leads, stinger, and ground clamps in good condition.
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5.) Ground attached to work or as near as possible.
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6.) Machine shut down when not in use.
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7.) Tongue jacks used and in good condition.
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8.) Welding leads routed overhead or in safe manner.
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9.) Welding leads secured with non-conductive material.
4.5 Oxygen/Acetylene Equipment
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1.) Oxy/fuel cylinders stored & secured in proper upright position.
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2.) Cylinders appropriately marked.
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3.) Flashback arrestors and/or anti-reverse check valves installed.
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4.) Gauges in good working condition and not over-pressured.
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5.) When not in use, cylinder caps installed.
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6.) Bulk storage areas for Oxygen/Acetylene physically separated or 5" wall installed between.
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7.) All cylinders either in use or in bulk storage properly secured.
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8.) Cutting hoses in good condition.
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9.) Cylinders stored away from heat source.
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10.) Not left unattended while inside confined space.
4.6 Ladders
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1.) Ladders used properly where required
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2.) Ladders equipped with anti-slide shoe devices on bottom.
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3.) Ladder properly inspected and in good condition.
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4.) Metal ladders not used around electric equipment.
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5.) Ladder properly positioned and secured.
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6.) Ladder is free of entanglement hazards such as cords or rope.
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7.) Ladder access unobstructed and extends at least 3ft.platform
4.7 Scaffolds
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1.) Erected in accordance with appropriate OSHA standards.
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2.) Plywood, 3/4" used appropriately and where required.
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3.) Toe boards installed.
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4.) #18 gauge wire mesh installed on scaffold over or near walkways.
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5.) Hand rail and mid rail installed.
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6.) Visible scaffold tag completed.
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7.) Scaffold material in good condition and inspected.
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8.) Erected under direction of a "Competent" Person.
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9.) Scaffold braced or otherwise free of movement.
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10.) Access ladder properly installed.
4.8 Motor Vehicle
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1.) Operator properly qualified.
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2.) Safety checklist or daily inspection performed.
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3.) Operated or driven at a safe speed.
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4.) Wheels choked when parked on incline.
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5.) Not left running while unattended.
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7.) Running lights, work lights, backup alarm, and horn operational.
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8.) Seat belts installed and worn.
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9.) Authorization obtained to be in process unit.
4.9 Miscellaneous Hand Tools
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1.) Chisels, hammer wrenches, or other striking surface tools free of mushrooming.
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3.) Impact socket, knuckle joints in good condition.
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4.) Tools properly maintained and inspected.
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5.) Tools which have been modified not in use.
4.10 Utility Hoses
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1.) Utility hoses (white) equipped with Chicago Connector.
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2.) All hoses are in good condition with proper connectors
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3.) All hoses are routed overhead or in a safe manner.
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4.) Hose clips (safety clips) or whip checks installed are adequate
Section 5. General Work Environment
5.1 Floors
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1.) No slip, trip, or fall hazards.
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2.) Floor openings closed, covered, or guarded.
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3.) Clean, orderly, and free of oil and grease.
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4.) Non-slip surfaces where needed.
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5.) Grates over surface or floor drains.
5.2 Aisles
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1.) Clearly marked.
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2.) Un-obstructed.
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3.) Sufficiently wide for work being performed.
5.3 Lighting
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1.) Sufficient lighting for work being performed.
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2.) GFCI in use for portable lighting.
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3.) 12 volt lighting provided where required and run properly
5.5 Occupational Noise Considerations
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1.) Hearing protection required signs located on perimeter of high noise areas.
5.6 Fire Protection/Prevention
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2.) Fire extinguishers with current inspection.
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3.) Fire extinguisher locations clearly marked.
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4.) Fire extinguishers of the proper size & type and in good condition.
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5.) Flammables/combustible liquids kept in safety cans and are labeled
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6.) Fire watch in place for hot work activity
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7.) Trash & other combustible material away from heat source.
5.7 Housekeeping & Sanitation
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1.) Work area neat and orderly.
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2.) Waste containers provided and used.
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3.) Lunch/eating areas clean and free hazards.
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4.) Wash facilities adequate and clean.
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5.) Restrooms clean and adequately available.
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6.) Current date on drinking water (taped & dated).
5.8 Barricades
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1.) Are barricades used to detour passage of persons or vehicles in hazardous areas?
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2.) Are yellow barricades used to warn of overhead work hazard?
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3.) Are red barricades used to warn of immanent dangers?
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4.) Are purple barricades used to warn of radiation hazards?
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5.) Are wood or rigged barricades used for floor/wall opening and excavations?
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6.) Are lights placed on road barricades for night time traffic?
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7.) Are barricades used around swing radius of cranes?
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8.) Are barricades removed when hazard has been ?
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9.) Are barricades tagged for specific hazards ?
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10.) Barricades used to protect personnel?
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11.) Barricades are adequately installed to protect workers?
Section 6. Procedures
6.1 Permits
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1.) All provisions of permit being followed.
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2.) Permit posed at job site.
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3.) All employees have read, signed, and understand permit.
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4.) All hazards listed on back of permit corresponds to job.
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5.) Appropriate permit issued for task.
6.2 Lockout/Tagout
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1.) Being used where required.
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2.) Authorized contractor employee have installed LOTO devices.
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3.) Employees properly trained.
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4.) Locks/Tags unique to contractor.
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5.) All potential energy sources identified on LOTO sheets.
6.3 Confined Space Entry
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1.) Proper permits maintained.
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2.) Sign in/out log maintained.
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3.) Entry attendant assigned and familiar with requirements.
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4.) Ventilation (mechanical) installed.
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5.) All personnel trained in their specific tasks.
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6.) Method of communication established.
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7.) Entry points unobstructed.
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8.) Signs posted at each entry point.
6.4 Hazard Communication
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1.) MSDS readily available
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2.) Employees knowledgeable in obtaining info. on hazardous chemicals
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3.) Employees trained in the requirements of the Program.
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4.) Labels on drums and containers.
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5.) Proper Personal Protective Equipment being used.
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6.) Proper storage of material as required (fire cabinet etc.).
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7.) Proper absorbent or spill control material on site.
6.5 Emergency Procedures
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1.) Employees familiar with unit evacuation.
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2.) Familiar with designated assembly areas.
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3.) Shelter in place areas designated and known by employees.
6.6 Miscellaneous Procedures
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1.) JSA completed and available.
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2.) JSA identifies task and hazards.
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3.) JSA signed by all employees.
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4.) Personal H2S Monitor not covered by clothing.
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5.) Personal H2S Monitor properly tested.
Section 7. Respiratory Protection
7.1 Respirator Use
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1.) Respirator selection is appropriate for the task.
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2.) Employees are medically certified.
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3.) Being used where required.
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4.) Employees are properly fit tested.
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5.) Respirators are being used appropriately.
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6.) Respirators are being maintained in a sanitary condition.
7.2 Supplied Air Respirator
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1.) Respirators are properly maintained.
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2.) Air supply hose does not exceed 300ft.
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3.) Hose fittings are compatible with equipment manufacturer.
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4.) Air supply system is adequate for the number of persons on the task.
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5.) Stand-by person is at the job site and the work is within sight.
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6.) Breathing air is Grade "D" quality.
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7.) If a Compressor is used to supply breathing air:
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a.) A Carbon Monoxide monitor is installed and working properly.
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b.) A High Temperature Alarm is installed and working properly.
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c.) An air filtration device is installed and in good condition.
Section 8. Management Participation
8.1 Safety Meetings
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1.) Does the jobsite superintendent conduct weekly safety meetings with all supervisors/foremans.
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a.) Is this meeting documented and maintained on file for inspection.
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2.) Does supervisor/foreman (with assistance of site safety rep. if available) hold weekly safety meetings for all employees.
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a.) Is this meeting documented and maintained on file for inspection.
8.2 Jobsite Inspections
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1.) Does the jobsite superintendent conduct a weekly documented safety performance observation.
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2.) Is there documentation of corrected deficiencies found on their observation.
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3.) Employees conduct a weekly documented job observations safety performance observation.
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4.) Is there documentation of corrected deficiencies found on this observation.
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5.) Do field safety personnel conduct at least two documented job site safety observations per week.
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6.) Is there documentation of corrections to any deficiency found on this observation.
Section 9. General Work Practices
9.2 Electrical & Power Tools
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1.) Electrical cords safe for use.
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2.) Guards in place and properly adjusted.
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3.) Fingers not on switch while carrying tools.
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4.) Constant pressure safety switch in working order.
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5.) Observers a safe distance from work areas.
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6.) Electrical tools are double insulated type.
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7.) Tools not lifted by cords.
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8.) Tools unplugged when not in use.
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9.) Lose clothing and jewelry not worn while operating tool
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10.) Defective tools tagged "Do Not Use".
10.3 Body, Use, & Position
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1.) Employees working out of line of fire.
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2.) Employees using proper body mechanics while working.
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3.) Employees using proper safe body techniques while walking on, climbing on, or gaining access to work locations.
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4.) Employees are not placing a part or all of the body in a position to be caught between two or more objects.
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5.) Employees in their work environment do not have to perform work in restricted body positions or having to extend their bodies to reach work.
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6.) Employees are performing work from or on a stable surface.
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7.) Employees obtain assistance from others in the work crew when required to avoid a potential injury.
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8.) Employees are using proper work techniques when working around material that contains high temperatures.
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9.) Employees are performing work activities in a manner as to not produce un-do stress on their bodies.
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Select date
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Signature of Auditor
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Branch Acknowledgement Signature
